Journal of the Indian Medical Association
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Of 63 patients of obstetrical acute renal failure, 15 cases (23.8%) had biopsy proven bilateral renal cortical necrosis. Remaining 48 patients (76.2%) had acute tubular necrosis. Eight of 39 cases in early pregnancy had cortical necrosis (postabortum) and 7 of 24 patients in late pregnancy revealed cortical necrosis. ⋯ The incidence of cortical necrosis was almost equal in both early as well as late pregnancies. The high incidence (20.5%) of cortical necrosis following septic abortion remains the interesting feature of the present study in contrast to very low incidence (1.5%) of cortical necrosis in postabortum group in developed countries. The death occurred in most patients (14 ie, 93.3%) of cortical necrosis because of uraemic complications and sepsis.
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Two hundred and eight patients of low back pain were studied in the department of orthopaedic surgery, GSVM Medical College, Kanpur. The patients were put on intensive conservative treatment in the form of analgesics, hard bed rest, spinal extension exercises, traction and lumbosacral support. Thirty-two patients did not respond to this treatment and their symptoms were of more than 6 months duration and they were subjected to epidural injection of local anaesthetic agent, saline and corticosteroids. ⋯ The aim of this study is to develop standardised strategy for the treatment of low back pain. For the low back pain patients not responding to intensive conservative treatment, an idea has been put forward in the form of epidural medication prior to considering them to surgery to prevent unnecessary incidence of "failed back". A trial of epidural injection is suggested to avoid surgery.
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Several methods of treatment, both surgical and conservative have been tried for subdural haematoma. No single method is perhaps applicable to all the cases and an individualised treatment is necessary. This review comprising 100 patients of which 26 with subacute and 74 with chronic subdural haematoma attempts to evaluate the experience with different surgical techniques at one centre in order to highlight some guiding principles in the treatment. ⋯ Six patients died in this series. Fifty-one patients were followed up to a period of one year with a recurrence in 9 cases. Seven patients with a follow-up for 2 years and 3 patients up to 2-4 years had no recurrence detected.